Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 0104000242 | VA |
NPI | 1366544934 |
---|---|
Provider Name | Dr. Alan Paul Krasnoff |
First Address | Chesapeake, VA 23320-4735 |
Second Address | Chesapeake, VA 23320-4735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
075017 | ANTHEM (01) | VA |
460132 | ASHN (01) | VA |
460253 | ACN (01) | VA |
541210056 | (02) | VA |